Short-term outcome of ascending aorta replacement combined with total aortic arch fenestration technique for acute type A aortic dissection
- VernacularTitle:升主动脉置换+弓部覆膜支架三开窗手术治疗急性Stanford A型主动脉夹层的早期临床结果
- Author:
Xiantao MA
1
;
Zhangqiang ZHU
1
;
Yi FENG
1
;
Shiliang LI
1
;
Akilu Wajeehullahi
1
;
Xiang WEI
1
;
Cai CHENG
1
Author Information
1. Department of Cardiac and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, P. R. China
- Publication Type:Journal Article
- Keywords:
Acute type A aortic dissection;
thoracic endovascular aortic repair;
fenestration technique;
endovascular treatment;
hybrid technique;
branched stent-graft
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(05):577-584
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report our clinical experience and outcomes of thoracic endovascular aortic repair (TEVAR) for acute Stanford type A dissection using ascending aorta replacement combined with implantation of a fenestrated stent-graft of the entire aortic arch through a minimally invasive technique. Methods From 2016 to 2020 in our hospital, 24 patients (17 males and 7 females, aged 45-72 years) with complicated Stanford type A aortic dissection, underwent replacement of the proximal ascending aorta with TEVAR. None of the patients with dissection involved the three branches of the superior arch, and all patients were replaced with artificial blood vessels of the ascending aorta under non-hypothermic cardiopulmonary bypass, preserving the arch and the three branches above the arch, and individualized stent graft fenestration. Results Surgical technical success rate was 100.0%. There was no intraoperative complication or evidence of endo-leak in 1 month postoperatively. Hospital stay was 10±5 d. During postoperative follow-up, the stent was unobstructed without displacement, the preserved branch of the aortic arch was unobstructed, and the true lumen of the descending aorta was enlarged. Conclusion This hybrid technique by using TEVAR with fenestrated treatment is a minimally invasive and effective method to treat high-risk patients with acute Stanford type A aortic dissection.
